Peroneus longus autograft with lateral extra-articular tenodesis for revision anterior cruciate ligament surgery has excellent short-term outcomes

Objectives Revision of failed anterior cruciate ligament (ACL) surgery has consistently shown poorer clinical outcomes and lower return to sport rates than the primary ACL surgery. We investigated the clinical outcomes of using a peroneus longus (PL) graft for revision ACL surgery combined with a lateral extra-articular tenodesis procedure. Materials and Methods Institutional ethics approval was obtained before the initiation of the study. Thirty consecutive patients were prospectively recruited with clinical and radiological evidence of ACL reconstruction failure and followed up for a one-year duration. Knee outcomes (Visual Analog Scale [VAS], International Knee Documentation Committee (IKDC) and Lysholm) scores, return to sport rates, ankle outcome measures (American Orthopedic Foot and Ankle score and functional ankle disability index), and complications were assessed. Results All thirty patients were males with an average age of 28.9 ± 4.4 years. One third of the study population comprised athletes. Excellent knee and ankle outcomes were observed, with significant improvement in VAS, IKDC, and Lysholm scores over the study duration. The re-rupture rate in the entire study population was 7%, with a return to sport rate of 93% and a return to sport at a pre-injury level of 73% at an average duration of 10.8 months post-surgery. Conclusion The use of PL graft combined with lateral extra-articular tenodesis in revision ACL surgery provides excellent clinical outcomes with a high return to sport rate and a low complication rate.